Provider Demographics
NPI:1649203613
Name:DOI, STANLEY HIDETOSHI (OD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:HIDETOSHI
Last Name:DOI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:11671 MOONRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-1781
Mailing Address - Country:US
Mailing Address - Phone:562-695-7474
Mailing Address - Fax:323-262-4401
Practice Address - Street 1:4939 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-3114
Practice Address - Country:US
Practice Address - Phone:323-262-1183
Practice Address - Fax:323-262-4401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5515T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0055150OtherCALIFORNIA MEDI-CAL
CA3298OtherMEDICAL EYE SERVICES, INC
CA3298OtherMEDICAL EYE SERVICES, INC
CA0860170001Medicare ID - Type UnspecifiedCIGNA